Skin Tag: You're It

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DEAR MAYO CLINIC: Where do skin tags come from? As I age, I feel like I get more and more, and they appear out of nowhere. Are they harmful at all? Can I do something to get rid of them myself, or do I need to see a skin doctor? Some of them are really unsightly.

ANSWER: Skin tags are common and, as in your situation, can become even more common as people age. We don't know what causes skin tags. But the good news is that they aren't cancerous, and they don't pose any other health concerns. The technique for removing them is simple and usually effective. But to avoid unnecessary health risks, skin tag removal should be performed under the guidance of a physician. I don't recommend that people attempt home remedies.

Skin tags (also called achrocordons, soft fibromas or fibroepithelial polyps) are small noncancerous (benign) skin growths. Usually, they are flesh-colored bumps of tissue connected to the skin's surface by a narrow stalk. The color, texture, size and width of the base can vary.

Friction may play a role in development of skin tags. Commonly they are located where skin rubs against skin or clothing. Frequently, they develop on the neck, underarms and eyelids, as well as within body folds, such as under the breasts or in the groin area. In some cases, skin tags seem to be associated with obesity, and genetic factors also appear to play a role. Unfortunately, there's no way to minimize the risk of developing skin tags.

Most skin tags don't cause symptoms unless they're repeatedly irritated by rubbing against jewelry, clothing or other items. The tags are harmless but they won't go away without treatment. Reasons for having them treated include irritation of a skin tag or if you don't like the way the skin tag looks. A physician -- most often a dermatologist (skin specialist) or someone who practices family or internal medicine -- should diagnose and treat skin tags. Occasionally, an ophthalmologist (eye specialist) may have to remove a tag located very close to the eyelid.

A physician should make the diagnosis, because other skin disorders can mimic the appearance of a skin tag. These include benign conditions such as moles, warts and seborrheic keratoses, as well as malignant skin cancers, including melanomas. In some cases, after removal, the physician may decide to submit the specimen to a pathology laboratory to rule out the possibility of a skin cancer.

Also, in rare cases, development of multiple skin tags may be a sign of an underlying hormonal or endocrine syndrome, such as polycystic ovary syndrome or acromegaly. So, medical evaluation is always recommended before treatment.

If the diagnosis is a benign skin tag, treatments include removal with sterile surgical scissors, freezing with liquid nitrogen, and electrical burning (cautery). These treatments often can be completed with minimal discomfort. Small tags are usually removed easily without anesthesia, while larger growths may require some local anesthesia prior to removal. For multiple tags, applying an anesthetic cream before the procedure may help. If the skin tag is large or has a broad base, a physician may decide that removal via surgical excision is necessary.

Removal of skin tags is not completely without risk. A skin tag can be removed immediately in the office with surgical scissors or excision, but minor bleeding or even a local infection could occur. With freezing or burning, the skin tag may require a short time to fall off, and these procedures have a risk of skin discoloration (darkening or lightening) following the procedure. Sometimes, repeat treatments are necessary if the tag doesn't fall off, or grows back, or if new tags grow in other areas.

If you're interested in having skin tags removed, talk to your doctor. Perhaps the condition can be treated during an office visit. Or, you may be referred to a dermatologist for evaluation. Simple, effective treatments are available. -- Marcus Frohm, M.D., Dermatology, Mayo Clinic, Rochester, Minn.